Data Analyst Operations

Job Overview:

Pay Range: $42.20hr - $47.20hr

Requirement/Must Have:

• Associate degree or equivalent experience required.
• At least 5+ years of experience working within a core claims administration system.
• A minimum of 2+ years of experience writing SQL queries and exporting data from database tables into Excel for analysis.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Ability to work independently or as a part of a team.
• Ability to manage multiple complex assignments at once.
• Mandatory OIG/GSA/OFAC Exclusion Screenings prior to start date.
• Monthly OIG/GSA/OFAC screenings required for the duration of the assignment.
• Completion of mandatory compliance training including General Compliance, HIPAA, Fraud, Waste, and Abuse, and Conflict of Interests Acknowledgement.
• Completion of Security Awareness training including Fundamentals, AI Threats and Devices, and Fraud Integral Staff Training.
• Completion of Model of Care, ODAG, and CA Fair Claims training.

Responsibilities:

• Serve as a Data Analyst on the Business Configuration team, responsible for the structure and benefit plan set up for managed vision care clients.
• Provide subject matter expertise for product configuration in the Facets system.
• Partner with cross-functional teams to ensure efficiency and accuracy of configuration requests.
• Configure all types of managed vision care products in the system using both the Product Key Sheet method and manual configuration.
• Ensure product configuration accuracy utilizing configuration tools for manual and automated product creation.
• Write SQL queries and export from database to analyze and troubleshoot configuration issues.
• Perform issue resolution of requests and resolve product configuration questions independently.
• Maintain relationships with Implementation Managers and Account Managers to develop a cohesive results-driven environment.
• Self-manage completion of work inventory in production queues within established quality and turnaround time service levels.
• Coordinate and participate in cross-functional team activities for issue resolution.
• Recommend process and system enhancements to drive improvements.
• Support the management team with on-going training activities and special projects.

Nice to Have:

• 3+ years of experience in Operations in the Healthcare industry.
• Experience understanding claim adjudication for member and provider reimbursements.
• Experience with Facets platform using Claims, Provider, Network, Product Benefit Configuration.
• Knowledge of Medicare and Medicaid programs.

Skills:

• SQL.
• Facets.
• Data Analysis.
• Product Configuration.
• Microsoft Excel.
• Claims Administration.
• Managed Vision Care.
• Database Troubleshooting.

Qualification And Education:

• Associate degree or equivalent experience.